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Malignant cough equivalent asthma: definition and case reports
M M Millar1, K G McGrath, R Patterson
1Department of Medicine, and the Ernest S. Bazley Asthma and Allergic Diseases Center of Northwestern Memorial Hospital and Northwestern University Medical School, Chicago, Illinois 60611, USA.
Summary
Malignant cough equivalent asthma causes severe chronic cough, often disrupting sleep and daily life. This condition requires higher oral corticosteroid doses for initial management.
Area of Science:
- Pulmonology
- Allergy and Immunology
Background:
- Cough equivalent asthma is a common cause of chronic cough, typically managed with corticosteroids.
- Oral corticosteroids are used for diagnosis and initial treatment, while inhaled corticosteroids are for maintenance.
- Severe cases may necessitate escalated oral corticosteroid doses for initial control, termed malignant cough equivalent asthma.
Observation:
- Two cases of chronic cough, severe enough to disrupt sleep and daily activities, are presented.
- One patient experienced an emergency room visit and hospitalization due to the severity of the cough.
- Standard treatments for cough equivalent asthma were ineffective, prompting consideration of a more severe form.
Findings:
- Malignant cough equivalent asthma is characterized by chronic cough significantly impacting sleep and daily life.
- This severe asthma variant can lead to emergency room visits or hospitalization.
- Effective initial management involves escalated doses of oral corticosteroids.
Implications:
- Physicians should consider malignant cough equivalent asthma in patients with severe, disruptive chronic cough unresponsive to standard therapy.
- Prompt recognition and appropriate corticosteroid escalation can improve patient outcomes.
- This condition highlights the spectrum of cough equivalent asthma severity and management needs.
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